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Sepsis in the Context of Nonventilator Hospital-Acquired Pneumonia
Karen K Giuliano1, Dian Baker2
1Karen K. Giuliano is an associate professor, The Institute for Applied Life Sciences and College of Nursing, University of Massachusetts, Amherst.
Background:
Sepsis is a leading cause of mortality among hospitalized patients and is the most expensive condition affecting the US health care system. Pneumonia is associated with about half of sepsis cases, yet limited research has described the incidence of sepsis in the context of nonventilator hospital-acquired pneumonia (NV-HAP). Persons with NV-HAP who are at risk for sepsis must be identified so that interventions to reduce the burden of NV-HAP and improve outcomes among patients with sepsis can be designed.
Objective:
To determine the proportion of persons with NV-HAP in whom sepsis develops and to describe the demographic and clinical characteristics of persons with NV-HAP in whom sepsis develops.
Methods:
In this retrospective, population-based study, data were extracted from the National Inpatient Sample from the 2012 Healthcare Cost and Utilization Project dataset. International Classification of Diseases, Ninth Revision, Clinical Modification codes were used to identify adult patients at least 18 years of age who had a stay of at least 48 hours, had no documented diagnosis of ventilator-associated pneumonia, and had secondary diagnoses of both NV-HAP and sepsis, neither of which was present on admission.
Results:
In the 2012 calendar year, 119 075 adults had NV-HAP develop; sepsis developed in 36.3% of these cases. Male and black patients were overrepresented in the sample, and patients had a mean of 7 comorbid conditions (SD, 3.3).
Conclusions:
Sepsis in the context of NV-HAP is a key concern. Additional research is needed to identify factors associated with the development of sepsis among patients with NV-HAP.
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